• Title/Summary/Keyword: N2 disease

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Optimal Scheme of Postoperative Chemoradiotherapy in Rectal Cancer : Phase III Prospective Randomized Trial (직장암의 근치적 수술 후 화학요법과 방사선치료의 순서)

  • Kim Young Seok;Kim Jong Hoon;Choi Eun Kyung;Ahn Seung Do;Lee Sang-Wook;Kim Kyoung-Ju;Lee Je Hwan;Kim Jin Cheon;You Chang Sik;Kim Hee Cheol
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.53-61
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    • 2002
  • Purpose : To determine the optimal scheme of postoperative chemoradiotherapy in rectal cancer by comparing survival, Patterns of failure, toxicities in early and late radiotherapy groups using a Phase III randomized prospective clinical trial. Materials and Methods : From January 1996 to March 1999, 307 patients with curatively resected AJCC stage II and III rectal cancer were assigned randomly to an 'early (151 patients, arm 1)' or a 'late (156 patients, arm II)' and were administered combined chemotherapy (5-FU $375\;mg/m^2/day$, leucovorin $20\;mg/m^2$, IV bolus daily, for 3 days with RT, 5 days without RT, 8 cycles with 4 weeks interval) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Patients of arm I received radiation therapy from day 1 of the first cycle of chemotherapy and those of arm II from day 57 with a third cycle of chemotherapy. The median follow-up period of living patients was 40 months. Results : Of the 307 patients enrolled, fifty patients did not receive scheduled radiation therapy or chemotherapy. The overall survival rate and disease free survival rate at 5 years were $78.3\%\;and\;68.7\%$ in arm I, and $78.4\%\;and\;67.5\%$ in arm II. The local recurrence rate was $6.6\%\;and\;6.4\%$ (p=0.46) in arms I and II, respectively, no significant difference was observed between the distant metastasis rates of the two arms ($23.8\%\;and\;29.5\%$, p=0.16). During radiation therapy, grade 3 diarrhea or more, by the NCI common toxicity criteria, was observed in $63.0\%\;and\;58.2\%$ of the respective arms (p=N.S.), but most were controlled with supportive care. Hematologic toxicity (leukopenia) greater than RTOG grade 2 was found in only $1.3\%\;and\;2.6\%$ of patients in each respective arm. Conclusion : There was no significant difference in survival, patterns of failure or toxicities between the early and late radiation therapy arms. Postoperative adjuvant chemoradiation was found to be a relatively safe treatment but higher compliance is needed.

Clinical Characteristics and Prognostic Factors of Nasopharyngeal Cancer (비인강암의 임상적 고찰과 예후인자)

  • Bai, Chang-Hoon;Seo, Young-Jung;Ye, Sang-Baik;Choi, Young-Ho;Kim, Yong-Dae;Song, Si-Youn
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.72-80
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    • 2005
  • Background: Nasopharyngeal cancer is a rare disease with a relatively poor prognosis because it tends to be diagnosed at an advanced stage. The aim of this study was to establish the clinical characteristics of nasopharyngeal cancer. Materials and Methods: The medical records of 54 patients with nasopharyngeal cancer from January 1993 to December 2002 were reviewed retrospectively. Forty one cases were male (75.9%) and thirteen were female (24.1%). The average age was of 46.9 (range 16 to 78 years) years. The majority of patients (79.6%) were diagnosed in the advanced stage. The most common complaints were a neck mass (55.5%) and the WHO type III (53.7%) was the most frequent histological type. Results: The cumulative survival rate for a 5-year period was 46.5% and the T stage, N stage, pathologic type, and clinical stage were not significantly related to the survival rate. Sixteen of 54 (31.5%) cases presented with a distant metastasis of the bone, lung, brain, spine, and liver, and six cases (11.1%) presented with a locoregional recurrence. Conclusion: TNM staging is not appropriate for predicting survival rate of nasopharyngeal carcinoma patients. Therefore, a newer staging system, which includes new factors, is needed to predict the prognosis.

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Hematologic Characteristics of Intrauterine Growth Restricted Small for Gestational Age Infants (자궁 내 성장지연으로 인한 부당 경량아의 혈액학적 특징)

  • Kim, Soon-Ju;Cho, Il-Hyun;Cho, Yeon-Soo;Youn, Young-Ah;Lee, Ju-Young;Lee, Hyun-Seung;Lee, Jung-Hyun;Sung, In-Kyung;Kim, So-Young
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.248-256
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    • 2011
  • Purpose: Intrauterine growth retardation (IUGR) is the term used to designate a fetus that has not reached its growth potential. However it is difficult to make a distinction between infants who are constitutionally small and growth restricted small. In the present study, we focused on the clinical characteristics and the hematologic value in small for gestational age (SGA) infants and discussed how to distinguish intrauterine growth restricted infants from constitutionally small infants. Methods: SGA infants that did not have any other risk factors for IUGR in the medical record except maternal hypertension (HTN) and diabetes mellitus (DM) and born at the Seoul St Mary's Hospital and Yeouido St Mary`s Hospital from January 2007 to July 2010 were included. The frequency of IUGR is higher in the pregnancy with medical problem, and in preterm infants. Therefore, the data was categorized by maternal disease and gestational age. We assessed the clinical data and the hematologic value. Results: The leukocyte count and the platelet count were lower in the SGA with maternal HTN group and the preterm SGA group. There was no difference in the clinical data and the prognosis resulted from maternal HTN and maternal DM. However, the hematologic difference was not found in the categorization of the preterm SGA group as maternal diasease. Conclusion: The results of this study showed that it is possible the low leukocyte count and the low platelet count are the characteristic hematologic features in growth restricted small for gestational age infants.

ATHEROSCLEROSIS, CHOLESTEROL AND EGG - REVIEW -

  • Paik, I.K.;Blair, R.
    • Asian-Australasian Journal of Animal Sciences
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    • v.9 no.1
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    • pp.1-25
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    • 1996
  • The pathogenesis of atherosclerosis can not be summarized as a single process. Lipid infiltration hypothesis and endothelial injury hypothesis have been proposed and investigated. Recent developments show that there are many points of potential interactions between them and that they can actually be regarded as two phases of a single, unifying hypothesis. Among the many risk factors of atherosclerosis, plasma homocysteine and lipoprotein(a) draw a considerable interest because they are independent indicators of atherogenicity. Triglyceride (TG)-rich lipoproteins (chylomicron and VLDL) are not considered to be atherogenic but they are related to the metabolism of HDL cholesterol and indirectly related to coronary heart disease (CHD). LDL can of itself be atherogenic but the oxidative products of this lipoprotein are more detrimental. HDL cholesterol has been considered to be a favorable cholesterol. The so-called 'causalist view' claims that HDL traps excess cholesterol from cellular membranes and transfers it to TG-rich lipoproteins that are subsequently removed by hepatic receptors. In the so-called 'noncausalist view', HDL does not interfere directly with cholesterol deposition in the arterial wall but instead reflects he metabolism of TG-rich lipoproteins and their conversion to atherogenic remnants. Approximately 70-80% of the human population shows an effective feedback control mechanism in cholesterol homeostasis. Type of dietary fat has a significant effect on the lipoprotein cholesterol metabolism and atherosclerosis. Generally, saturated fatty acids elevate and PUFA lower serum cholesterol, whereas MUFA have no specific effect. EPA and DHA inhibit the synthesis of TG, VLDL and LDL, and may have favourable effects on some of the risk factors. Phospholipids, particularly lecithin, have an antiatherosclerotic effect. Essential phospholipids (EPL) may enhance the formation of polyunsaturated cholesteryl ester (CE) which is less sclerotic and more easily dispersed via enhanced hydrolysis of CE in the arterial wall. Also, neutral fecal steroid elimination may be enhanced and cholesterol absorption reduced following EPL treatment. Antioxidants protect lipoproteins from oxidation, and cells from the injury of toxic, oxidized LDL. The rationale for lowering of serum cholesterol is the strong association between elevation of plasma or serum cholesterol and CHD. Cholesterol-lowing, especially LDL cholesterol, to the target level could be achieved using diet and combination of drug therapy. Information on the link between cholesterol and CHD has decreased egg consumption by 16-25%. Some clinical studies have indicated that dietary cholesterol and egg have a significant hypercholesterolemic effect, while others have indicated no effect. These studies differed in the use of purified cholesterol or cholesterol in eggs, in the range of baseline and challenge cholesterol levels, in the quality and quantity of concomitant dietary fat, in the study population demographics and initial serum cholesterol levels, and clinical settings. Cholesterol content of eggs varies to a certain extent depending on the age, breed and diet of hens. However, egg yolk cholesterol level is very resistant to change because of the particular mechanism involved in yolk formation. Egg yolk contains a factor of factors responsible for accelerated cholesterol metabolism and excretion compared with crystalline cholesterol. One of these factors could be egg lecithin. Egg lecithin may not be as effective as soybean lecithin in lowering serum cholesterol level due probably to the differences of fatty acid composition. However, egg lecithin may have positive effects in hypercholesterolemia by increasing serum HDL level and excretion of fecal cholesterol. The association of serum cholesterol with egg consumption has been widely studied. When the basal or control diet contained little or no cholesterol, consumption of 1 or 2 eggs daily increased the concentration of plasma cholesterol, whereas that of the normolipemic persons on a normal diet was not significantly influenced by consuming 2 to 3 eggs daily. At higher levels of egg consumption, the concentration of HDL tends to increase as well as LDL. There exist hyper-and hypo-responders to dietary (egg) cholesterol. Identifying individuals in both categories would be useful from the point of view of nutrition guidelines. Dietary modification of fatty acid composition has been pursued as a viable method of modifying fat composition of eggs and adding value to eggs. In many cases beneficial effects of PUFA enriched eggs have been demonstrated. Generally, consumption of n-3 fatty acids enriched eggs lowered the concentration of plasma TG and total cholesterol compared to the consumption of regular eggs. Due to the highly oxidative nature of PUFA, stability of this fat is essential. The implication of hepatic lipid accumulation which was observed in hens fed on fish oils should be explored. Nutritional manipulations, such as supplementation with iodine, inhibitors of cholesterol biosynthesis, garlic products, amino acids and high fibre ingredients, have met a limited success in lowering egg cholesterol.

An Analysis on Elementary School Students' Oral Health Knowledge and Education Effect in School-Based Oral Health Clinic (학교구강보건실 운영 초등학교 학생의 구강보건지식과 교육효과분석)

  • Yang, Jin-Young
    • Journal of dental hygiene science
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    • v.14 no.2
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    • pp.248-255
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    • 2014
  • The objective of the paper is to analyze the extent to which elementary school students acquired, perceived, and practiced oral health knowledge provided by an elementary school-based oral health clinic (SBOHC). It is respectively investigated by gender and year of school. The paper will be relevant for developing specified oral health programs in elementary SBOHCs. By choosing three elementary schools that operate SBOHC in the school district of Daejeon Metropolitan City from April 11 to April 30, 2013, a self-administered questionnaire was given out to be answered directly by 350 students in the 4th, 5th, and 6th grades and their responses were collected. Of the collected responses, 326 responses were explored by using the SPSS 12.0. Those students' scores of oral health knowledge are found to be statistically meaningful for school year, not for gender. In them are included correct tooth brushing time, dental caries symptoms, gum disease symptoms, and correct tooth brushing method. Change in tooth brushing method after oral health education showed the statistically meaningful difference for gender and school year. In conclusion, every SBOHC should develop a variety of specified educational programs that depend on gender and grade in each elementary school.

Study on the Clonality of Endothelial Cell Proliferation in Plexiform Lesions in Patients with Pulmonary Hypertension Associated with CREST Syndrome (CREST 증후군에 동반된 폐고혈압 환자에서 총상병변내 내피세포 증식의 클론성에 관한 연구)

  • Lee, Sang-Do;Jeon, Yong-Gam;Lee, Ji-Hyun;Shim, Tae-Sun;Lim, Chae-Man;Koh, Yun-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Tuder, Rubin M.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.150-160
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    • 1999
  • Background: The CREST syndrome is an indolent form of progressive systemic sclerosis. Although its clinical progress is indolent, pulmonary hypertension(PH) associated with CREST syndrome have grave prognosis with over 40 percent mortality rate at 2 year follow-up. But the pathogenesis of pulmonary hypertension in this disease is not known, and classified as either primary or secondary PH. Clonality of endothelial cell proliferation in plexiform lesion is a molecular marker which allows distinction between primary and secondary PH. We performed this study to know whether the PH associated with CREST syndrome is a variant of primary PH or is a secondary PH. Methods: We assessed the X-chromosome inactivation based on the methylation pattern of the human androgen-receptor gene by PCR(HUMARA). Endothelial cells in plexiform lesions from female patients(n=3) with PH associated with CREST syndrome were microdissected from paraffin blocks. Vascular smooth muscle cells and lung parenchyma were also microdissected for clonality studies. Results: The proliferating endothelial cells in 14 plexiform lesions were all polyclonal. Similarly proliferated smooth muscle cells from 5 vessels with medial hypertrophy were also polyclonal. Conclusion: These results suggest that the pulmonary hypertension associated with CREST syndrome has different pathogenesis from primary PH and to be classified as secondary PH.

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Physicochemical Changes of Swine Manure by the Treatment of Acid and Alkali for Inactivation of Pathogenic Microorganisms (병원성미생물의 불활성화를 위한 산·알칼리처리가 양돈분뇨의 이화학적 성상에 미치는 영향)

  • Kim, Cho-Long;Kim, Soo-Ryang;Kim, Ha-Je;Jeon, Sang-Joon;Han, Ho;Kim, Dong-Kyun;Lee, Myung-Gyu
    • Journal of Animal Environmental Science
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    • v.18 no.3
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    • pp.229-234
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    • 2012
  • Disinfecting contaminated swine manure with FMD (Foot-and-Mouth Disease) and pathogenic viruses is very important for maintaining sanitized environment. However, very few research reported on this subject, especially post-disinfection to utilize the wastes as a renewable resource. This research is carried out to obtain basic information for chemical treatment in FMD SOP (Standard Operating Procedure, Korea) of contaminated swine manure. Using lime, sodium hydroxide, citric acid and hydrochloric acid, described in FMD SOP, the effects of chemical treatments on livestock manure were compared in this paper. Four combinations of alkali-acid treatments and four kinds of acid-alkali combinations were tested to find out the effective method. Total coliform bacteria in contaminated swine manure, $1.6{\times}10^4$ CFU/100 ml, decreased to the range of 1/1000~1/100 in all treatments. Some specific disinfectants increases BOD (Biochemical Oxygen Demand) and EC(Electric Conductivity), especially, alkaline treatments increases ammonia level than acid treatments. These findings suggest that the treatment methods should be considered as an important environmental factor in post-disinfection of contaminated animal manure with pathogenic microorganisms.

The Monitoring of Heavy Metals in Human Bloods of Middle School Students (중학생의 혈액 중 중금속 모니터링)

  • Park Hee Ra;Kim Meehye;Kwun Ki-Sung;Kim Soon Ki;Heo Su-Jeong;Kim Kwang_Jin;Yum Tae-Kyung;Choi Kwang Sik;Kim Soo Yeon
    • Journal of Food Hygiene and Safety
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    • v.20 no.2
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    • pp.83-88
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    • 2005
  • This study was conducted to estimate the contents of heavy metals including lead, cadmium, zinc, copper as well as iron status(serum iron, total iron binding capacity, feritin etc)in blood samples of middle school students(n=300). The contents of heavy metals were determined using the GF-AAS (Graphite furnace Atomic Absorption Spectrophotometer). The microwave digestion method and dilution method were compared. The dilution method showed the better recovery and detection limit than microwave digestion method. The values of toxic metals in whloe blood of boys & girls were 3.46 & 3.05 for Pb,0.063 & 0.065 for Cd respectively (ug/dL). Also the values of trace metals in serum of boys & girls were 105.9 & 92.6 for Zn, 98.3 & 99.0 for Cu respectively (ug/dL). The prevalence of iron deficiency was $7.5\%$ in 146 boys and $14.3\%$ in 156 girls. The mean values of lead in girls were higher in iron deficiency, iron deficiency anemia and anemia groups than normal group. The mean values of lead and zinc were higher in boys compared to those in girls(P<0.05), the mean values of cadmium and copper in boys were similar to those in girls. Our results of toxic metals such as Pb & Cd showed lower to CDC's(Centers for Disease Control) blood lead levels of concern for children, 10 ug/dL.

A study of pain perception related to IV therapy in hospitalized preschool children and their mothers (정맥주사와 채혈시 학령전기 아동과 어머니가 인지하는 동통)

  • 임지영
    • Journal of Korean Academy of Nursing
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    • v.22 no.1
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    • pp.49-67
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    • 1992
  • Most hospitalized children will experience physical pain as well as psychological distress. Preschool children's pain perception related to painful procedures can increase due to elevated anxiety and fear because they do not have understanding logical of their disease and hospitalization. In particular, they are distressed about needle - related procedures which are feared because they are seen to be a cause of bodily damage. This descriptive study attempted to identify pain perception levels in preschool children and their mothers. A self-reporting measurement and behavioral observation were used to collect the data. A total of 25 hospitalized preschool children and their mothers were investigated and data were collected about 60 painful procedures. Data collection was carried out by the researcher and two trained investigators from November first to December tenth. Three insruments were used to collect the data : Faces Pain Rating Scale(FPRS) developed by Beyer was used to measure the degree of preschool children's pain perception about painful procedures. The Visual Analogue Scale(VAS) devised by Huskisson was used to assess the degree of mothers' pain perception about their children's painful procedures. A Pain Behavioral Checklist based on the Procedure Behavior Check List by LeBaron and Zelter and modified by the researcher was used to observe behaviors of preschool children, their mothers, and nurses when the painful procedures took place. The data were analyzed by an SPSS program, and were tested using real numbers, percentages, Pearson correlation coefficient, t-test, and ANOVA. The results of this study are as follows : 1. Of all the painful procedures, the mean score for the FPRS for the preschool children's pain perception was 4.02 points, and the mean score for the VAS of mothers' pain perception was 10.92 points. 2. A Positive correlation which was statistically significant was found between the pain perception of preschool children and their mothers (r=.53, p<.01). that is, the higher the children's pain perception was, the higher their mothers' pain perception was. 3. The characteristics of the painful procedures related with children's pain perception as follows : The type of painful procedure was found to be statistically significant (F=23.44, p<.01), Among the three procedures Ⅳ starting was found to be perceived as the most painful procedures to the children. The greater the number of times that the procedure had been done, the higher the pain perception was (F=4.44, p<.01), and the longer the duration of the procedure, the higher the pain perception wa(r=.30, p<.05). Pain perception in the treatment room was higher than in the children's room(t=6.30, <.01), pain perception in the mother's presence was the higher than when the mother was not present (t=2.91, p<.01). 4. The characteristics of the painful procedures related with the mothers' pain perception as follows : The type of painful procedure was found to be statistically significant(F=6.01, p<.01). Among the three procedures Ⅳ sampling was found to be perceived as the most painful procedures to the mothers. The greater the number of times that the procedure had been done, the higher the pain perception was (F=5.95, p<.01), and the longer the duration of the procedure, the higher the pain perception was (r=.31, p<.05). Pain perception in the treatment room was higher than in the children's room (t=3.51, p<.01), but pain perception in the mother's presence showed statistically significant no difference. 5. Of all of the 19 children's behaviors during the painful procedures, the most frequent behaviors observed Were as follows in order of frequency “crying”, “screamirig”, “facial grimacing”, “physical resistance”, Of all of the nine methers' behaviors, the most frequent by observed in “console children”, “hold children”, “applaud children”, Of all of the 11 nurses' behaviors during the painful procedures, the mast frequent in order were “smiling”, “physical restraint”, “console children”, “praise children”. 6. A positive correlation between children's and mothers' pain perception and children's behaviors was found to be statistically significant (r=.65, p<.01, r=67, p<.01). Also the relationship between children's and mothers' pain percertion, and mothers' behavior was found to be statistically significant (r=.57, p<. 01, 4=.60, p<.01). The relationship between children's pain perception and nurses' behaviors was also found to be statistically significant (r=.46, p<.01), but there was difference between mothers' pain perception and nurses' behaviors.

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A New Soybean Cultivar, "Sohwang" for Sprout with Disease Resistance, Small Seed Size and High Sprout yielding (내병·소립 고수율 나물콩 신품종 "소황")

  • Cho, Sang-Kyun;Oh, Young-Jin;Kim, Kyong-Ho;Kim, Young-Jin;Kim, Tae-Soo;Kim, Jung-Gon;Park, Ki-Hun;Yun, Hong-Tae;Kim, Hyun-Tae;Han, Won-Young;Baek, In-Youl;Ko, Jong-Min;Kim, Yong-Duk;Kim, Dong-Kwan;Hwang, Hung-Goo
    • Korean Journal of Breeding Science
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    • v.41 no.4
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    • pp.640-644
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    • 2009
  • A new sprout-soybean cultivar, "Sohwang" was developed at the National Institute of Crop Science (NICS) in 2008. "Sohwang" was selected from a cross between Pungsan and Pungsan/Nattosan. The preliminary, advanced, and regional yield trials to evaluate the performance of Iksan 58 were carried out from 2004 to 2008. This cultivar has a determinate growth habit with purple flower, grayish brown pubescence, yellow seed coat, Yellow hilum, lanceolate leaflet shape and small seed size (8.5 grams per 100 seeds). The maturity date of "Sohwang" is 10 days earlier than the check variety, "Pungsan". It has a good seed quality for soybean-sprout. The soybean-sprouts grown from "Sohwang" have high isoflavone ($3,041{\mu}g/g$)contents. This cultivar has resistance to soybean mosaic virus (SMV) and necrotic symptom (SMV-N), and other most troublesome soybean diseases which are bacterial pustule and black root rot. Especially, "Sohwang" has useful characteristics, such as lodging and shattering resistance. The average yield of "Sohwang" was 2.69 ton per hectare in the carried out for three years from 2006 to 2008 regional yield trials(RYT) for double cropping.